Pregnancy Loss and Infertility Across Generations

A three-generation genogram of a fictional British-Ghanaian and Irish family that records every kind of pregnancy outcome: two miscarriages, a stillbirth and IVF in the current generation, a current pregnancy, and an unspoken stillbirth and a terminated pregnancy in the generation above. Shows pregnancy-loss symbols in birth order and family secrets.

Grace O’Brien (41), a teacher, is 2026’s index person: pregnant again after two miscarriages (2016, 2017), a diagnosis of endometriosis, IVF, the stillbirth of her son Noah at 37 weeks in 2019 and the birth of her daughter Ada in 2021. Her anxiety is rising as the anniversary of Noah’s due date approaches. Her depression after the stillbirth is shown as in recovery.

The previous generation holds losses that were never discussed. Grace’s mother Esi, a midwife, had a miscarriage in 1987 and ended a pregnancy in 1993; the children were never told. Liam’s mother Maureen had a stillborn daughter in 1984 who was never named; Liam learned of her only after Noah died. Both are recorded as secrets on the chart. The parallel between Maureen’s silence and Liam’s withdrawal from Grace (drawn as a distant line) is a useful focus for couple work.

The chart is also a reference for placing pregnancy outcomes correctly: losses keep their place in birth order with their year, so Grace is the eldest of four pregnancies in her family of origin and Noah is the third of five in hers.